OPTIMIZE ~ CUSTOMIZE ~ NANCERCIZE

Nancy Bruning, lifestyle coach, certified personal trainer, outdoor

fitness program creator, and author of 25 books on health and
fitness
www.nancercize.com
Nancercize@gmail.com
419-962-6292
fax: 212-927-7174 (call first)

Date ______, 2010

Dear ______,

Welcome! You have decided to slim down and shape up with a smile. You
are going to Nancercize, not agonize. You are beginning a marvelous
journey towards being the best that you can be.

I’m looking forward to being your coach and guiding you through this
process. To help that process run more smoothly and be more effective, I’d
like to help you first understand what coaching is. I’ve also included a few
forms to take care of as well, that you will either email or fax back to me or,
if we are meeting face to face, bring to our first session.

1. Policies and procedures—read carefully

2. Coaching agreement – read, sign, and fax or bring to first session
3. Commitment form – sign and fax or bring to first session
4. Client information form-- fill out the top and fax to me or bring to first
session
5. Client tracking form – fill out the top and fax to me or bring to first
session
6. Daily accountability journal form— fill in one sheet each day for one
week. You may make 7 copies and fill in by hand and bring to your
first session; or fill in electronically, print and bring to your first session
or email back to me as an attachment.

What Is coaching?
Maybe you’ve already tried to achieve a healthier weight, to eat healthier
and exercise smarter and with more joy, to handle stress better. It’s not
easy doing this on your own. That’s why I’m here. As a coach, I have been
trained to listen, to observe, and to customize my approach to each client’s
needs. I use the Transitions Lifestyle System, which was based on a book I
wrote with Dr. Shari Lieberman called “Dare to Lose.” This system was
developed by a team of scientists including Dr. Lieberman and is a
scientifically-based system that educates you about healthier eating, smarter
exercise, targeted nutritional supplements, and ways to de-stress and
reprogram your brain and body to prefer healthier habits.

Coaching is NOT: therapy, counseling, or mentoring. Coaching focuses on

your strengths, not your weaknesses. It looks at the future, not the past. It is
our mutual commitment to forward thinking and forward actions. It is an
interactive and result-oriented process that brings about change.

Remember: Change does not occur overnight, and it doesn’t occur

automatically. You need to actually make the effort! For me to coach you,
you must be coachable!

How do you get the most out of coaching?

In my role as coach, either in a group setting or one-on-one, I seek to elicit
solutions and strategies from my clients; I believe that they are naturally
creative and resourceful. I will provide support to enhance your skills, your
resources, and your creativity. I will help you discover strengths and energy
you might not have known you had.

Education about the most up to date wellness and weight loss information is
necessary and a good start, but it’s not enough. That’s why I use tools and
techniques that have been shown to be the most effective ways we know to
change human behavior. These include goal-setting, group or individual
support and feedback, keeping a log and a journal, assignments and
exercises, accountability, and skills enhancement. These are all part of a
tested system, and they all work together. If something does not work for
you, we will customize it so it does.

The following suggestions will help maximize the value of our sessions and
the results you achieve. I want you to succeed!

Thoughtful goals
Coaching works best when you have clear goals, something we can work
towards. Together we will discuss and clarify your goals and then customize
the Transitions System to fit your resources, strengths, and needs (and those
of the group, if you are having group coaching) to help you achieve your
goals.

Flexibility in thoughts and actions

To benefit the most from the coaching process, you need to be willing to try
new approaches to old problems and also to let go of the same old solutions
and old approaches that are not working. Reframing your perspective on
food, exercise, supplements, and relaxation can be extraordinarily powerful if
you are open to it.
This goes beyond calorie counting or calorie burning… it may entail
examining your long-held assumptions and decisions and trying new ways of
seeing and doing things.

Preparation
Each session includes a review of the previous week – how did you do? what
were your challenges? how did you meet them, or not? what were your
victories? How will you handle them the next time? What challenges do you
see looming in the future? The journaling and assignments will guide you in
identifying and recording this information. It also helps to do some self-
reflection before the session so you are clear about what you need from the
session. Remember, most of the results of your coaching will occur outside of
the sessions as you work on things by yourself as you go through your day-
to-day life. I’m here to keep you enthused and focused and help you
acknowledge and celebrate and learn from your wins.

Monitoring, accountability, and honesty

As your coach, I act as someone that you are accountable to and this helps
enormously with your success in staying on track. If you are in a group, the
members of the group will also be doing this for each other. We will be
keeping track of your measurements and weight on the first session and
each month after that. We will also be reviewing your daily logs and journals.
For this system to work, you need to be honest and open and be willing to
communicate. If you are uncomfortable sharing some information in a group
setting, please let me know.

Weekly assignments
Each week, you will receive informational and coaching handouts and
reading assignments in either the Transitions Workbook or via emailed
documents. These are designed to convey information outside the sessions
in an efficient manner, and as tools to help you discover more about
yourself, understand your strengths, limitations, resources, set your goals,
and make course corrections along the way. I usually also ask you to commit
to one action each week at the end of the session, which is designed to help
you move forward. There is a saying in my field that “If a client takes no
action, then coaching did not occur.”

Feedback
Helping you depends on my understanding what you are saying and what
you need. I will ask for feedback often. Please feel free to give me honest
feedback. If something is great, tell me. If something isn’t working for you,
please tell me. If I misunderstand or upset you in any way, please tell me,
either verbally or in an email. Part of life-changing coaching is to have
courageous conversations. You may need to have these conversations with
others in your life, as you make changes in your lifestyle that may affect
other people. Others in your life may find the changes you are making
troubling or threatening. Practice having courageous, honest conversations
with me. I will value and affirm your bravery and you will give me the
opportunity to examine and change as well.

Warmly,

Nancy
Nancy Bruning
 OPTIMIZE ~ CUSTOMIZE ~ NANCERCIZE
Nancy Bruning, lifestyle coach, certified personal trainer, outdoor
fitness program creator, and author of 25 books on health and
fitness
www.nancercize.com
Nancercize@gmail.com
419-962-6292

Date ______, 2010

POLICIES AND PROCEDURES
Welcome to my practice of wellness and weight loss coaching. Please take a
moment to look over my policies and procedures. If you have any questions,
you can email me anytime at nancercize@gmail.com

Contract
Our coaching agreement or contract is an “at-will” alliance and we both
reserve the right to terminate this partnership at any time. All actions and
decisions are yours and you alone are responsible for the results of these
choices. As your coach, I will encourage, motivate, guide and help you
achieve your successes. The real work is yours; how far you go and how fast
you get there is up to you.
If we are doing individual coaching, at the end of our first session I will make
a recommendation for how many sessions I think would benefit you most.
We will also discuss the frequency of sessions that best fits your needs and
both of our schedules. At the end of our agreed upon sessions, we will re-
evaluate and either end coaching, begin to taper off or continue working on
new goals that have arisen as we work together.
Ethics and Confidentiality
I follow and maintain the ethical guidelines set out by the International
Coaching Federation:
Regarding Confidentiality:
22) I will respect the confidentiality of my client's information, except as
otherwise authorized by my client, or as required by law.
23) I will obtain agreement from my clients before releasing their names as
clients or references, or any other client identifying information.
24) I will obtain agreement from the person being coached before releasing
information to another person compensating me.
I practice strict, yet not absolute, confidentiality. In some rare instances in
which I have reason to think that some party is in danger I am expected to
report that concern to the appropriate authority and the endangered party.
Otherwise I hold to the principle that what goes on in our meetings is
completely between us. Regarding phone calls and electronic emailing /
messaging, I will do everything within my power to protect your information
on my personal and private computer which installed with regularly updated
protective software. This computer is used only by me.
INDIVIDUAL COACHING: FEES and SESSION LENGTH

During the first session, we will both be evaluating how we fit: Does my
training and experience equip me to be of help to you and will the kind of
service I offer and the feel of my practice fit with you well enough for us to
work together?
Each session is 45 minutes long. I do not charge any fee for the first trial
session. Thereafter, my fee is US$___ per session or US$___ for 4 sessions (1
month) paid in advance, US $___ for 12 sessions (3 months) paid in advance,
or US $____ for 24 sessions (6 months) paid in advance. The rates are
cheaper if you take a 1, 3 or 6-month package.
PAYMENT
Payment by check is expected in advance, unless we arrive at a different
arrangement. This represents a commitment on both our parts.

Once you schedule an appointment it takes up that part of my day. I will

reserve that time for only you and expect you pay for it whether you choose
to use it or not.

HOW TO REACH ME

I check my email and voicemail frequently throughout the day. I do my best

to return messages on the same day that I receive the message.

-In Summary-

1. Payment is expected at the time of services rendered, if not before.

2. You are responsible for the cost of missed sessions.
3. Strict not absolute confidentiality
 OPTIMIZE ~ CUSTOMIZE ~ NANCERCIZE
Nancy Bruning, lifestyle coach, certified personal trainer, outdoor
fitness program creator, and author of 25 books on health and
fitness
www.nancercize.com
Nancercize@gmail.com
419-962-6292

COACHING AGREEMENT

Once we have discussed this in the first session, please review, adjust, sign
where indicated, and fax to me at the above fax number. If you are unsure of
anything, we can discuss it.

YOUR NAME: _____________________________________________________________

INITIAL TERM: ____ MONTHS, FROM _____________ THROUGH _______________
FEE $_______ PER MONTH / $ ___________ for the project
SESSION DAY ___________________ SESSION TIME _________________
NUMBER OF SESSIONS PER MONTH __________________
DURATION ___________________ (length of scheduled session)
REFERRED BY: ______________________________________________

GROUND RULES:
1. CLIENT CALLS THE COACH AT THE SCHEDULED TIME.
2. CLIENT PAYS COACHING FEES IN ADVANCE
3. CLIENT PAYS FOR LONG-DISTANCE CHARGES, IF ANY
4. As a client, I understand and agree that I am fully responsible for my
physical, mental and emotional wellbeing during my coaching calls,
including my choices and decisions. I am aware that I can choose to
discontinue coaching at any time.
5. I understand that “coaching” is a Professional-Client relationship I have
with my coach that is designed to facilitate the creation/development
of personal, professional or business goals and to develop and carry
out a strategy/plan for achieving those goals.
6. I understand that coaching is a comprehensive process that may
involve all areas of my life, including work, finances, health,
relationships, education and recreation. I acknowledge that deciding
 how to handle these issues, incorporate coaching into those areas, and
implement my choices is exclusively my responsibility.
7. I understand that coaching does not involve the diagnosis or treatment
of mental disorders as defined by the American Psychiatric Association.
I understand that coaching is not a substitute for counseling,
psychotherapy, psychoanalysis, mental health care or substance abuse
treatment and I will not use it in place of any form of diagnosis,
treatment or therapy.
8. I promise that if I am currently in therapy or otherwise under the care
of a mental health professional, that I have consulted with the mental
health care provider regarding the advisability of working with a coach
and that this person is aware of my decision to proceed with the
coaching relationship.
9. I understand that information will be held as confidential unless I state
otherwise, in writing, except as required by law.
10. I understand that certain topics may be anonymously and
hypothetically shared with other coaching professionals for training OR
consultation purposes.
11. I understand that coaching is not to be used as a substitute for
professional advice by legal, medical, financial, business, spiritual or
other qualified professionals. I will seek independent professional
guidance for legal, medical, financial, business, spiritual or other
matters. I understand that all decisions in these areas are exclusively
mine and I acknowledge that my decisions and my actions regarding
them are my sole responsibility.

I have read and agree to the above.

Client Signature

Date: ____________________________
 TRANSITIONS LIFESTYLE SYSTEM COMMITMENT

I ___________________________________________________ am making a
commitment to myself and my coach Nancy Bruning that,

[ ] I am making a commitment to change my life, my perspective,

and my attitude.
[ ] I will follow instructions and be honest in my journal.
[ ] I will finish the program we have agreed upon.
[ ] I will not get discouraged if I have a bad day and do something
that I am not supposed to do.
[ ] I will not compare myself to others.
[ ] I will not complain. I understand that everything in this
program is to help me change my life.

Signature: __________________________

Date: _____________________________
 OPTIMIZE ~ CUSTOMIZE ~ NANCERCIZE
Nancy Bruning, lifestyle coach, certified personal trainer, outdoor
fitness program creator, and author of 25 books on health and
fitness
www.nancercize.com
Nancercize@gmail.com
419-962-6292

CLIENT MEASUREMENTS TRACKING CHART

Client Name _________________________________________

Height: ___________ Sex: _________ Age: _______

Measure Star 4 8 12 Chang 6 12 Total

t week week week e month month change

Neck
Chest/bus
t
Waist
Abdomen
Hips
Bicep -R
Bicep- L
Thigh- R
Thigh - L
Weight

Size- top
Size- bot

BMI
W:H ratio
Rest. HR
Flex.
 CLIENT INFORMATION
Date: ________________

Name: ______________________________________________________
Address: ____________________________ City: _________ Zip: ______
Phone: Home: ____________ Work: _____________ Cell: ___________
Email: _______________________________________________________

BRIEF MEDICAL HISTORY

Are you Currently Under a Physicians Care? YES____ NO_____
Do you have any of the following? (Check all that applies and elaborate)
Heart Condition_____ Heart Disease _____ High Blood Pressure ______
Diabetes_______ Depression ________ High Cholesterol _______
Other (please describe): _________________________________________
_____________________________________________________________
Are you taking prescription medications? If so, please specify what:
_____________________________________________________________
_____________________________________________________________
Did you notice weight gain after using these medications? ____________
Do you smoke? YES_____ NO_____
Do you drink alcohol? NO___ YES_____ How often? _______
Do you drink sodas? NO____ YES______ How often? _______
What type? Regular _____ Diet ______
Do you drink regular (caffeinated) coffee? ______ Other caffeine drinks? _______
Do you take any nutritional supplements? If so, please specify which:
_____________________________________________________________
_____________________________________________________________
Do you have any chronic pain or current injuries? If so, please specify:
_____________________________________________________________
_____________________________________________________________
Do you have any other health information we should be made aware of?
_____________________________________________________________
_____________________________________________________________

I understand that I should consult a physician before beginning this or any other
diet and exercise program.
_______________________________
Signature
DAILY ACCOUNTABILITY JOURNAL DATE: _______________
NAME: ____________________________

MEAL TIME DESCRIPTION

BREAKFAST

LUNCH

DINNER

SNACK

EXERCISE:

ACTIVITY DURATION COMMENTS

SUPPLEMENTATION:

SUPPLEMENT TIMES A DAY COMMENTS

JOURNALING: